Aerobic exercise and cognitive stimulation show no significant between-group cognitive benefits in schizophrenia trial

A 12-week randomized controlled trial assigned 58 patients with schizophrenia to an aerobic exercise group (n=18), a computer-based cognitive stimulation group (n=20), or a control group (n=20) receiving no intervention. The primary outcomes assessed at 12 weeks included cognition, clinical symptoms, depression, and quality of life.

Between-group comparisons showed no statistically significant differences for general cognitive function, executive function, or depression. However, significant differences were observed for specific PANSS and quality of life subscales. Within-group analyses revealed improvements in general cognitive function, clinical symptoms, and selected quality of life domains for the aerobic exercise group. The cognitive stimulation group showed significant improvements across cognitive functions, clinical symptoms, depressive symptoms, and multiple quality of life domains. In contrast, the control group showed significant deterioration in cognitive functions, selected clinical symptoms, depressive symptoms, and certain quality of life domains.

Safety and tolerability data were not reported. Key limitations include the small sample size, which reduces statistical power and generalizability, and the lack of a sham or active control for the interventions, making it difficult to isolate specific treatment effects from non-specific factors like attention and engagement. The 2.8-month follow-up period is also relatively short for assessing sustained effects in a chronic condition.

For clinical practice, these findings suggest that structured non-pharmacological interventions may be associated with subjective or within-patient improvements, but they did not demonstrate clear superiority over no intervention in direct group comparisons for core cognitive outcomes. The observed deterioration in the control group highlights the potential importance of structured activity but requires confirmation in larger, more robustly controlled trials.